The Leading Provider of Advanced Neurostimulation Products
Advanced Neurostimulation The Magstim range of magnetic stimulation systems provide a variety of high quality solutions for researchers and clinicians working within Neurology, Neuroscience, Psychiatry and Rehabilitation. Magstim has substantial expertise in magnetic stimulation, and is a leader in the field, offering a wide range of magnetic stimulators and stimulating coils to suit a variety of clinical and research applications.
Non-invasive Neuromodulation Magnetic stimulation is a non-invasive and painless method of stimulating human tissue using strong, time varying magnetic fields to induce small currents in nerve tissue. These are able to stimulate the human cortex, spinal roots and peripheral nerves. Depending on the application a variety of output waveforms may be used to excite or inhibit nerve response. These pulses can be either monophasic or biphasic, or a combination of the two. This brochure is intended for users of TMS equipment outside of the USA.
“ a leader in the field Users of Magstim Transcranial Magnetic Stimulators in the USA please note: Caution - Investigational Device. Federal (or United States law) limits device to investigational use.
Magstim
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Monophasic single pulse systems are favoured in neurological applications due to the accuracy of the stimulation and the low heat output. For repetitive stimulation that is used in neuroscience and psychiatry, biphasic systems are the preferred option due to their ability to produce short and efficient pulses at high frequency. Magstim stimulators can be used in combination with equipment such as: i ● fMRI ● EMG ii ● EEG iii iv ● Image-guided TMS ● tDCS / tACS Magstim 200²
Magstim BiStim²
Magstim Rapid²
Magstim Rapid² Plus¹
Monophasic
Monophasic Twin Pulse
Biphasic
Biphasic
2.80kV
2.50kV*
1.67kV
1.67kV
2.0s 3.0s 4.0s
2.0s 3.0s 4.0s
Single PSU - 50Hz Dual PSU - 100Hz Single PSU - 30Hz Dual PSU - 50Hz Single PSU - 15Hz Dual PSU - 25Hz
100Hz 97Hz 41Hz
Minimum Inter Stimulus Interval
N/A
1.0ms
N/A
N/A
Minimum Inter Train Interval
N/A
4.0s
0.5s
0.5s
Output Type Maximum voltage Maximum repetition rates (230V configuration)
30% 50% 100%
* Also available as 2.80kV
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of magnetic stimulation
Magstim
Magstim 2002 & BiStim2 - Monophasic Magstim produce two monophasic systems; the Magstim 200 and BiStim2, which are used extensively within the fields of neurology and neurophysiology. For accurate single pulse functionality, monophasic waveform systems are favoured for: ● ●
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Neurological research Cortical mapping and brain research Functional assessment of central motor pathways Early diagnosis, assessment and monitoring of nervous diseases, such as Multiple Sclerosis and Motor Neurone Disease.
Single pulse Magstim 2002 provides users with the ability to elicit cortical evoked potentials, quickly and easily, as a routine component of clinical and research assessment techniques, including: ● ● ● ● ● ● ● ●
Triple Stimulation Techniquev Resting Motor Threshold Active Motor Threshold Central Conduction Time Motor Evoked Potential Input-Output Curve Cortical Silent Period Motor Mapping
2
Magstim 2002 offers complete flexibility and can be interfaced with a wide range of commercially available EMG systems.The monophasic waveform provides a high degree of hemispheric accuracy, low noise and less coil heating than other pulse ●waveforms. 2 ●The Magstim 200 is backward compatible with all Magstim ●stimulating coils, via the coil adaptor.
● Controlled Trains ● Magstim BiStim2 offers the potential to combine two Magstim ●2002 units to provide fully programmable paired pulse stimulation ●through a single stimulating coil.The ability to change pulse intervals and to independently control the power level of each Magstim 2002 allows for precise sub- and supra-threshold conditioning and test pulses.This is invaluable for the investigation of Inter-Cortical and Intra-Cortical Inhibition and Facilitation. The inter-stimulus interval (ISI) of the two pulses is adjustable using either the integral stimulator controls, remote control coil or externally via triggering software offering complete user flexibility. Two ISI options offer maximum controllability: ● ●
1ms - 999ms in 1ms resolution 1.0ms - 99.9ms in 0.1ms resolution
BiStim2 has the added advantages of being able to sum the two single pulses provided by the Magstim 2002 stimulators to produce a single high power pulse equal to 113% of a single Magstim 2002, as well as having the functionality to connect two individual coils for interhemispheric stimulation.
Magstim
Magstim Rapid2 - Biphasic
Magstim Rapid2 has an unique inbuilt two channel EMG amplifier with integral system acquisition software including latency and amplitude measurements. The dedicated touch screen user interface with internal and external memory makes storage and retrieval of results straightforward. Connecting the optional thermal printer allows for the provision of hardcopies.
Magstim Rapid repetitive Transcranial Magnetic Stimulation (rTMS) devices are highly effective non-invasive biphasic magnetic stimulators designed to meet the exacting needs of those involved â—? at all levels of clinical and academic research. Highly efficient, â—? short duration biphasic pulses makes it very well suited to bilateral cortical stimulation and is used in many different areas of research, including: 2
Rapid2 can be used with other investigation tools such as fMRI, EMG, EEG, tDCS, tACS and Image-guided TMS over a broad range of protocols and is fully compatible with existing Magstim coils through customised hardware.
Cognitive Neurosciencevi - in the investigation of learningvii viii, memoryix, speechx, hearing, visual, perception and functional connection
Magstim Rapid2 Plus1 is an innovative enhancement to the Rapid2 and is the only system able to offer a significantly higher repetition rate at stimulation output of 30% and higher.This is particularly useful in applications using protocols such as Theta Burstxii, as the Magstim Rapid2 Plus1 is capable of up to 89% output at 50Hz.
Psychiatryxi - to influence specific brain function within the dorsolateral prefrontal cortex Neurophysiology - used in the stimulation of the peripheral and central nerve pathways
With the addition of a Plus1 module a single PSU Rapid2 can be easily upgraded to dual PSU performance, whereas the addition of the Plus1 module to a dual PSU Rapid2 make high powered protocols feasible.
Rehabilitation - used in the promotion of muscle recovery and the relief of nerve spasticity
100
Rapid2 Plus1 90
Dual PSU Rapid2 80
Single PSU Rapid2 (230v configurations)
70
Frequency (Hz)
The Magstim Rapid2 range of repetitive stimulators has been developed to maintain a consistent pulse amplitude/frequency during the delivery of stimulation trains through Single Pulse, Repetitive, Burst and Session modes of operation. Rapid2 stimulators offer frequencies of up to 100Hz, with a 0.1Hz frequency resolution for the first 30Hz.
60 50 40 30 20 10 0 0
10
20
30
40
50
60
70
Power (%)
Magstim Rapid2 Performance
80
90
100
Magstim
Stimulating coils There is a wide range of stimulating coils available for use with Magstim systems, offering a great level of flexibility to both research and clinical users: Single, Double and Placebo coils are available in a variety of sizes for specific, targeted stimulation and research protocols. It is now possible to achieve prolonged periods of stimulation ● the innovative Air Film Coil, created to work in combination with ● Magstim Rapid2 stimulators. with
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The Air Film Coil uses innovative, ambient air flow and ● temperature regulated fan technology to enable the cooled coil to run indefinitely under certain protocols. Key features of the Air Film Coil include: ● Delivers up to 3,000 pulses at 75% stimulator output at 10Hz stimulation (Biphasic waveform) over a 37.5 minute period and remains within allowed temperature limits (with a starting temperature of 22˚C). ● Extends the useful range of stimulating protocols available to researchers and clinicians ● Unlimited running time with certain protocols ● Quiet running
Single Coils 50mm Small Coil
Peripheral stimulation
● Facial nerve ● Superficial peripheral nerves
70mm Medium Coil
Peripheral stimulation or paediatric and infant TMS
● Peripheral nerves ● Cortical stimulation (paediatric)
Adult TMS
● Cortical stimulation (adult) ● Cervical nerve roots ● Lumbrosacral nerve roots
● 90mm High Power Coil ● ● ●90mm Remote Control Coil ● ●Double Coils ●Double 25mm B.I. Coil
Adult TMS - user interface on coil handle for easier control of stimulator
● Cortical stimulation (adult) ● Cervical nerve roots ● Lumbrosacral nerve roots
Accurate peripheral stimulation handle is perpendicular to coil head
● Facial nerve ● Superficial peripheral nerves ● Somatosensory evoked potentials
Double 40mm Coil
Accurate peripheral stimulation or accurate paediatric and infant TMS
● Peripheral nerves ● Cortical stimulation (paediatric)
Double 50mm Coil
Accurate adult TMS
● Cortical stimulation (adult) ● Peripheral nerves
D702 Coil (New design)
Accurate adult TMS
● Cortical stimulation (adult) ● Spinal roots ● Peripheral nerves
Double 70mm Remote Control Coil
Accurate adult TMS - user interface on coil handle for easier control of stimulator
● Cortical stimulation (adult) ● Spinal roots ● Peripheral nerves
Double 70mm B.I. Coil
Accurate adult TMS - handle is perpendicular to coil head
● Cortical stimulation (adult) ● Femoral nerve ● Back and neck
Double 110mm Cone Coil
Deep adult TMS - elicits responses from relaxed muscles of the lower pelvic floor and lower limbs
● Central motor disorders ● Spinal injuries ● Urology
Specialised Coils Double 70mm Air Film Coil
Built-in, active cooling for long stimulation protocols
Double 70mm Air Film Placebo Coil
Identical to the active coil (see above) other than the stimulating output. Suitable for double-blind trials
Double 70mm Cooled Coil
Powerful active cooled coil with external air extraction unit
Double 70mm MR Compatible Coil Custom Coils
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Psychiatry Cognitive neuroscience Neurology Neurophysiology Rehabilitation
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Psychiatry Cognitive neuroscience Neurology Neurophysiology Rehabilitation
● Power intensive protocols ● Long duration protocols
Suitable for use in MRI scanners up to 3T ● Brain imaging research Coils of various configurations and dimensions can be designed for specific customer applications
● Specifications can be defined by the customer
Magstim
Go one step further with Magstim Innovations As well as the comprehensive range of standard products, Magstim provides a unique design service through the expertise of ● the “Magstim Innovations” team. Inspired by forward thinking researchers, the Magstim Innovations team is a dedicated group of● engineers who are able to develop to order the products required to meet the exact needs of the research community. Magstim Innovations helps push the boundaries of neuromodulation and brain stimulation to new levels.
the ‘7 Step’ Pathway
Customer enquiry & Specifications
Outline design proposal
Manufacturing
Based on 20 years experience, Magstim has developed a simple '7 Step' pathway to successful product production.This process ensures the product is delivered to the customer's exact requirements and needs, when it is needed.
Feasibility evaluation
Design Confirmation
Testing & installation
Agreement
The Magstim Company Ltd Spring Gardens, Whitland Carmarthenshire SA34 0HR Wales UK T: +44 (0)1994 240798 E: sales@magstim.com
www.magstim.com References i Combining TMS
and fMRI: From 'virtual lesions' to functional-network accounts of cognition. Ruff CC, Driver J, Bestmann S. Cortex. 2008 Dec 6. [Epub ahead of print]
ii Combining TMS
and EEG to study cognitive function and cortico-cortico interactions. Taylor PC, Walsh V, Eimer M. Behav Brain Res. 2008 Aug 22;191(2):141-7. Epub 2008 Apr 1. iii Mapping of the human visual cortex using image-guided transcranial magnetic stimulation. Fernandez, E., Alfaro, A., Tormos, J.M., Climent, R., Martinez, M., Vilanova, H., Walsh, V., and Pascual-Leone, A. Brain Research Protocols 10:115-124, 2002. iv Complementary localization and lateralization of orienting and motor attention. Rushworth, Matthew F.S., Ellison, Amanda, and Walsh, Vincent. Nature Neuroscience, 4(6), June 2001. v Triple
stimulation technique (TST) in amyotrophic lateral sclerosis Leonid Komissarow, Jens D. Rollnik, Dessislava Bogdanova, Klaus Krampfl, F. A. Khabirov, Andon Kossev, Reinhard Dengler and Johannes Bufler Clinical Neurophysiology, Volume 115, Issue 2, Pages 356-360
vi Transcranial magnetic stimulation and cognitive neuroscience Vincent Walsh and Alan Cowey Nature Reviews – Neuroscience, Volume 1, October 2000, 73-79 vii The
Contribution of Primary Motor Cortex is Essential for Probabilistic Implicit Sequence Learning: Evidence from Theta Burst Magnetic Stimulation Leonora Wilkinson, James T. Teo, Ignacio Obeso, John C. Rothwell and Marjan Jahanshahi Journal of Cognitive Neuroscience
viii Transcranial
magnetic stimulation can measure and modulate learning and memory J Grafman E Wassermann Neuropsychologia 37 (1999) 159-167
ix Contribution
of noninvasive cortical stimulation to the study of memory functions A. Floela, L.G. Cohen Brain Research Reviews 53 (2007) 250–259
x Stimulating
language: insights from TMS Joseph T. Devlin and Kate E. Watkins Brain 130, (2007) 610–622
xi Applications
of TMS to Therapy in Psychiatry. Lisanby, Sarah H.; Kinnunen, Leann H.; Crupain, Michael J. Journal of Clinical Neurophysiology. 19(4):344-360, August 2002.
xii Exploring Theta
Burst Stimulation as an intervention to improve motor recovery in chronic stroke P. Talelli, R. Greenwood, J. Rothwell Clinical Neurophysiology, Volume 118, Issue 2, Pages 333-342
Users of Magstim Transcranial Magnetic Stimulators in the USA please note: Caution - Investigational Device. Federal (or United States law) limits device to investigational use. All standard products carry the mark, comply with the Medical Device Directive 93/42/EEC, and are manufactured under a Quality System certified to ISO 13485. © 2010 The Magstim Company Limited. Magstim®, and Air FilmTM are registered trademarks of The Magstim Company Limited. All specifications are subject to change. All material in this literature is produced in good faith
This brochure is intended for users outside the USA